Lehigh Valley Health Network said Monday it is planning to drop UnitedHealthcare insurance plans, a move that could lead to higher out-of-pocket costs for approximately 70,000 patients starting next year.
LVHN said the move comes after failed negotiations and continued decreases in reimbursements from UnitedHealthcare. In response, a spokesperson for UnitedHealthcare accused the health network of using consumers as “leverage.”
LVHN, part of Jefferson Health, said it had been negotiating with UnitedHealthcare on new contract terms for more than two years, but those efforts have failed. It sent a letter to UnitedHealthcare on Monday.
“Like all health systems, we are facing significant headwinds as costs rise faster than reimbursement,” Mark Whalen, Jefferson Health executive vice president and enterprise chief strategy and transformation officer, said in a statement. “Sustainable, fair payment is essential to maintaining access and quality for the communities we serve. When reimbursement falls substantially below negotiated levels, it threatens our ability to fulfill our mission of providing exceptional care to all patients.
“Our goal remains to reach a fair agreement with UnitedHealthcare that ensures fair reimbursement so that we can protect access to essential health services for patients.”
Lehigh Valley Health Network operates hospitals in Dickson City, Lackawanna County; Hazleton, Luzerne County; East Stroudsburg, Monroe County, and Pottsville, Schuylkill County.
If new agreements aren’t reached, contracts will end Jan. 25, 2026, for patients who have Medicare Advantage plans through UnitedHealthcare, and April 25, 2026, for patients with commercial insurance policies.
In a statement, a spokesperson for UnitedHealthcare, one of the country’s largest insurers, said it had delivered a proposal to LVHN in April and had yet to receive a counter proposal. The insurer said LVHN’s last contract proposal was made in December 2024, and included a nearly 30% price hike in the first year of the contract.
“Lehigh Valley is making misleading and potentially false public statements about the status of our relationship in the middle of the Medicare Annual Enrollment period presumably as a negotiating tactic,” UnitedHealthcare said. “We ask Lehigh Valley to join us at the negotiating table and work toward an agreement that is affordable rather than using consumers as leverage to significantly drive up health care costs for Pennsylvanians and local companies.”
In response, Whalen said UnitedHealthcare had implemented a multiyear, 30% price decrease “that was not agreed to, not accepted and not sustainable.”
“The only thing misleading here is UnitedHealthcare portraying this as a standard negotiation when, in fact, this is a direct result of United not abiding by the terms of the contract they agreed to,” he said in a statement. “… We have been actively attempting to resolve this issue for the past several years before issuing today’s termination notification.”
The move only affects patients seeking care at legacy LVHN hospitals and doctor offices. Jefferson Health has separate contracts with UnitedHealthcare that will remain in effect.
This is not the first time LVHN has moved to terminate contracts with an insurance company over what it says are unfair and inadequate reimbursements.
In November 2022, LVHN threatened to stop accepting Aetna plans for what it said was refusal to pay for health care provided to members and denying or delaying care. However, the health network and insurer reached a new agreement about a week later.
Terminating its contract does not mean UnitedHealthcare patients must stop seeing their LVHN doctors. However, it would mean they face higher costs, as providers would be considered out of network after the contracts end.
LVHN advises patients keep their current appointments, as coverage remains in effect.